This disclosure relates generally to image-guided surgery (or surgical navigation), and more particularly, to a registration apparatus and method for use in percutaneous spinal surgical navigation procedures with surgical navigation systems.
Surgical navigation systems track the precise location of surgical instruments in relation to multi-dimensional images of a patient's anatomy. Additionally, surgical navigation systems use visualization registration apparatus to provide the surgeon with co-registered views of these surgical instruments with the patient's anatomy.
Surgical procedures involving the spine typically require the formation of a relatively large incision through the skin of the patient adjacent the portion of the spinal column to be treated. The size of the surgical incision must be large enough to accommodate for the manipulation and/or placement of various surgical instruments and implants required for the surgical procedure. Additionally, if surgical navigation technology is to be used in association with the surgical procedure, the surgical incision must also accommodate the mounting of a dynamic reference or registration device to the spinal column. The dynamic reference or registration device is attached to the spinous process via a bone pin or clamp. For electromagnetic surgical navigation systems, an electromagnetic field generator or an electromagnetic sensor is typically attached to the registration device.
However, recent advances in surgical technology have led to many more minimally invasive surgical procedures being performed. One minimally invasive method for registering the spine is through the use of a small bone pin inserted through a small incision in the back and into a bone of the spinal column. This bone pin is often vulnerable to loosening from low-density bone such as in osteoporosis.
Relative motion between the dynamic reference or registration device and the patient can introduce imprecision into a navigation system. It is therefore important that the dynamic reference or registration device be securely and rigidly mounted to the patient while also being minimally invasive. A problem with conventional dynamic reference devices relates to their size, high-profile designs and inadequate methods of anatomical attachment. Conventional dynamic reference devices are large enough to potentially limit surgical access, their high-profile design poses an increased risk of unintentional contact or bumping, and the methods of anatomical fixation are prone to failure.
Therefore, it is desirable to provide apparatus and methods for mounting a surgical navigation registration device to the patient in a minimally invasive manner to reduce the size of the surgical incision, or by eliminating the surgical incision entirely in applications involving percutaneous surgical procedures.